- The risk estimating score sheets are only for persons without known heart disease.
- The Framingham Heart Study risk algorithm encompasses only coronary heart disease, not other heart and vascular diseases.
- The Framingham Heart Study population is almost all Caucasian. The Framingham risk algorithm may not fit other populations quite as well.
- For some of the sex-age groups in Framingham, the numbers of events are quite small. Therefore, the estimates of risk for those groups may lack precision.
- Other organizations are considering how the information from the Framingham risk algorithm, as well as other assessments of risk, might best be incorporated into clinical practice. As new information and guidelines become available, they will be added.
- The Framingham risk score estimates the risk of developing CHD within a 10-year time period. This risk score may not adequately reflect the long-term or lifetime CHD risk of young adults, which is: one in two for men and one in three for women.
- The presence of any CHD risk factor requires appropriate attention because a single risk factor may confer a high risk for CHD in the long run, even if the 10-year risk does not appear to be high.
- Since age is a prominent determinant of the CHD risk score, the 10-year hazards of CHD are, on average, high in older persons. This may over-identify candidates for aggressive interventions. Relative risk estimates (risk in comparison with low risk individuals) may be more useful than absolute risk estimates in the elderly.
- The score derived from this algorithm should not be used in place of a medical examination.
- Changes in Risk Factors and the Decline in Mortality from Cardiovascular Disease-The Framingham Heart Study. Pamela A. Sytkowski, Ph.D., William B. Kannel, M.D., and Ralph B. D’Agostino, Ph.D. N Engl J Med 1990; 322:1635-1641
- Wilson PW, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97:1837-1847.
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